Objective : To evaluate quality of life (QoL) evolution after pulmonary surgery with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 and the lung cancer specific module-LC13.
Methods : Between January 2002 and March 2004 QoL was prospectively recorded in 81 patients undergoing pulmonary surgery. Questionnaires were administered before surgery and at 1, 3, 6 and 12 months postoperatively. Lobectomy was performed in 49%, pneumonectomy in 15%, wedge resection in 21% and other interventions in 15%. Approaches : anterolateral thoracotomy 72%, posterolateral thoracotomy 16%, thoracoscopy 7% and sternotomy 5%. Preoperative response rate was 100%, at 1 month 67%, 3 months 78%, 6 months 79% and 12 months 80%.
Results : After a significant decrease one month postoperatively, patients' functioning improved during follow-up. Three months postoperatively, global QoL scores approximated baseline values indicating good recovery. However, deficits still appeared at 12 months in scores of emotional functioning (p=0.002) and pain items (p=0.025).
There were no significant differences in evolution of QoL scores between antero- and posterolateral thoracotomies, nor between lobectomy and pneumonectomy with exception of dyspnea after 3 months (p=0.041).
When comparing lobectomy with wedge resection there was a significant difference in dyspnea (1 month p=0.048, 3 months p=0.017, 6 months p=0.007, 12 months p=0.004) physical (1 month p=0.016, 6 months p=0.013, 12 months p=0.008) and emotional functioning (p=0.013) in favour of wedge resection.
Conclusion : After pulmonary surgery the duration of decline of QOL is less than 3 months. Significant differences in QoL subscales evolution were observed between wedge resection and lobectomy, but not between lobectomy and pneumonectomy. Significant differences in dyspnea were observed comparing lobectomy to wedge resection or pneumonectomy.